| Autor: |
Weijers L; Real World Strategy and Analytics, Mapi Group, Houten, The Netherlands. lweijers@mapigroup.com., Baerwald C; Department of Internal Medicine, Rheumatology Unit, University Hospital, Leipzig, Germany., Mennini FS; EEHTA-CEIS, Faculty of Economics, University of Rome 'Tor Vergata', Rome Italy and Institute of Leadership and Management in Health, Kingston University, London, UK., Rodríguez-Heredia JM; Department of Rheumatology, University Hospital of Getafe, Madrid, Spain., Bergman MJ; Drexel University College of Medicine, Philadelphia, PA, USA., Choquette D; Institut de Rhumatologie de Montréal, University of Montreal, Quebec, Canada., Herrmann KH; Bristol-Myers Squibb, Munich, Germany., Attinà G; Bristol-Myers Squibb, Rome, Italy., Nappi C; Bristol-Myers Squibb, Rome, Italy., Merino SJ; Bristol-Myers Squibb, Madrid, Spain., Patel C; Bristol-Myers Squibb, Princeton, NJ, USA., Mtibaa M; Bristol-Myers Squibb, Quebec, Canada., Foo J; Real World Strategy and Analytics, Mapi Group, Houten, The Netherlands. |
| Abstrakt: |
Rheumatoid arthritis (RA) is a chronic inflammatory disorder leading to disability and reduced quality of life. Effective treatment with biologic DMARDs poses a significant economic burden. The Abatacept versus Adalimumab Comparison in Biologic-Naïve RA Subjects with Background Methotrexate (AMPLE) trial was a head-to-head, randomized study comparing abatacept in serum anti-citrullinated protein antibody (ACPA)-positive patients, with increasing efficacy across ACPA quartile levels. The aim of this study was to evaluate the cost per response accrued using abatacept versus adalimumab in ACPA-positive and ACPA-negative patients with RA from the health care perspective in Germany, Italy, Spain, the US and Canada. A cost-consequence analysis (CCA) was designed to compare the monthly costs per responding patient/patient in remission. Efficacy, safety and resource use inputs were based on the AMPLE trial. A one-way deterministic sensitivity analysis (OWSA) was also performed to assess the impact of model inputs on the results for total incremental costs. Cost per response in ACPA-positive patients favoured abatacept compared with adalimumab (ACR20, ACR90 and HAQ-DI). Subgroup analysis favoured abatacept with increasing stringency of response criteria and serum ACPA levels. Cost per remission (DAS28-CRP) favoured abatacept in ACPA-negative patients, while cost per CDAI and SDAI favoured abatacept in ACPA-positive patients. Abatacept was consistently favoured in ACPA-Q4 patients across all outcomes and countries. Cost savings were greater with abatacept when more stringent response criteria were applied and also with increasing ACPA levels, which could lead to a lower overall health care budget impact with abatacept compared with adalimumab. |
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